In recent years, thyroid carcinoma is one of the most common malignant tumors worldwide, with papillary adenocarcinoma as the predominant pathological type and surgery as the main treatment option. Metastases frequently occur first in the central compartment where the sentinel lymph nodes are located. For patients with central compartment lymph node metastasis, central neck dissection has been becoming widely accepted by domestic and international scholars. However, as for cN0 tumor, whether or not prophylactic central neck dissection should be done is controversial. Here, the authors address the issues that include the anatomical features of the central compartment, and metastatic characteristics and high-risk factors as well as different views regarding prophylactic central neck dissection in cN0 papillary thyroid carcinoma, so as to enhance the understanding of this disease and provide reference for improvement in its treatment.